Effleurage, Petrissage, and Combined Manual Pressure Release Techniques for Trigger Points of Cervical Spine in Patients with Myofascial Pain Syndrome
DOI:
https://doi.org/10.55735/dyw4kx44Keywords:
Effleurage, Manual pressure release therapy, Myofascial pain syndrome, Petrissage technique, Trigger points, Visual analogue scaleAbstract
Myofascial pain syndrome is a musculoskeletal disorder that arises due to the presence of taut knots in fascia surrounding the muscle. These hypercontracted skeletal muscles or soft tissues are termed myofascial trigger points. These taut knots cause sensory, motor, and autonomic (vasoconstriction, pilomotor response, hypersecretion) symptoms. Worldwide prevalence rate of myofascial pain syndrome is 85%. The etiology of myofascial pain syndrome is unknown, but factors contributing are overuse of the muscle, repetitive exercise, and postural stress. Patients facing significant sensorimotor impairments are treated by physiotherapists who suffer from problems caused by myofascial pain syndrome. The cervical spine provides a greater range of motion compared to other vertebrae. Mostly trigger points develop in the cervical spine, especially in the trapezius and levator scapulae muscles. Common clinical characteristics of myofascial trigger points are pain on compression, local twitch response, muscle tightness, and local myofascial pain. Worldwide, many rehabilitation centers provide services to indoor and outdoor patients for quality treatment. Effleurage technique (stroking) is a unidirectional (distal to proximal) rhythmical gliding stroking movement of hands (palms, thumbs, fingers), sliding continuously over a tight muscular region to increase pliability of muscles. Petrissage technique (kneading) is an alternative to deep squeezing and relaxation of the tight fascia of muscle from proximal to distal by hands, thumbs, and fingers to increase localized blood flow. The combined manual pressure release technique is a combination of four techniques. Direct pressure technique (I & II) for ischemic compression and local stretching on a taut knot. Other is fascial techniques (III & IV) for improvement of mobility of fascia, connective tissues, intermuscular and intramuscular mobility. This concludes that these treatments are effective for myofascial pain syndrome patients, for improving range of motion, decreasing pain, and releasing myofascial trigger points in these patients.
Downloads
References
1. Sadeghnia M, Kajbafvala M, Shadmehr A. The Effect Of Friction Massage On Pain Intensity, Ppt, And Rom In Individuals With Myofascial Trigger Points: A Systematic Review. BMC Musculoskeletal Disorders 2025; 26(1): 250.
https://doi.org/10.1186/s12891-025-08372-x DOI: https://doi.org/10.1186/s12891-025-08372-x
2. Yadav R, Sharma S. Efficacy of Myofascial Release Therapy and Positional Release Therapy in Patients with Upper Trapezius Trigger Points: Study Protocol of a Double-blinded Randomized Clinical Trial. International Journal of Therapeutic Massage & Bodywork 2024; 17(4): 49-57.
https://doi.org/10.3822/ijtmb.v17i4.1041 DOI: https://doi.org/10.3822/ijtmb.v17i4.1041
3. Pavón MJG, Redondo IC, Vizcaíno VM, Morales AF, García PL, Bueno CÁ. Comparative Effectiveness Of Manual Therapy Interventions On Pain And Pressure Pain Threshold In Patients With Myofascial Trigger Points: A Network Meta-Analysis. The Clinical Journal of Pain 2022; 38(12): 749-60.
https://doi.org/10.1097/AJP.0000000000001079 DOI: https://doi.org/10.1097/AJP.0000000000001079
4. Aiswarya D, Chakravarthi CA, Pravallika L, Jain CJ. To Compare The Effectiveness Of Manual Pressure Release Therapy And Myofascial Release Technique In Subjects With Mechanical Neck Pain Due To Upper Trapezius Trigger Point. International Journal of Medical Science and Current Research 2025; 8(1): 320-327.
5. Wang S-Q, Jiang A-Y, Gao Q. Effect Of Manual Soft Tissue Therapy On The Pain In Patients With Chronic Neck Pain: A Systematic Review And Meta-Analysis. Complementary Therapies In Clinical Practice 2022; 49: 101619.
https://doi.org/10.1016/j.ctcp.2022.101619 DOI: https://doi.org/10.1016/j.ctcp.2022.101619
6. Trezza S. The Effects of Trigger Point Manual Therapy on Pain Intensity, Headache Frequency, and Medicine Consumption, in Individuals With Primary and Cervicogenic Headache: A Meta-Analysis: California State University, Fresno; 2024.
7. Bethers AH, Swanson DC, Sponbeck JK, et al. Positional Release Therapy And Therapeutic Massage Reduce Muscle Trigger And Tender Points. Journal of Bodywork and Movement Therapies 2021; 28: 264-70.
https://doi.org/10.1016/j.jbmt.2021.07.005 DOI: https://doi.org/10.1016/j.jbmt.2021.07.005
8. Shults JJ, Fritsch CA. Manual Therapies and Massage. Canine Sports Medicine and Rehabilitation 2025: 306-25.
https://doi.org/10.1002/9781394251452.ch11 DOI: https://doi.org/10.1002/9781394251452.ch11
9. Henry VB. Effect Of Manual Therapy On Patients with Osteo-Discogenic Spinal Stenosis: National University of Medical Sciences, 2023.
10. Maler M. Massage therapy and myofascial principles. Integrative Veterinary Medicine 2023: 63-9.
https://doi.org/10.1002/9781119823551.ch8 DOI: https://doi.org/10.1002/9781119823551.ch8
11. Juchli L. Effectiveness Of Massage Including Proximal Trigger Point Release For Plantar Fasciitis: A Case Report. International Journal of Therapeutic Massage & Bodywork Research Education & Practice 2021; 14(2): 22-29.
https://doi.org/10.3822/ijtmb.v14i2.635 DOI: https://doi.org/10.3822/ijtmb.v14i2.635
12. Lytras D, Iakovidis P, Kasimis K, Georgoulas V, Algiounidis I, Tarfali G. Effects Of Simultaneous Soft Tissue Mobilization And Capacitive And Resistive Electric Transfer Therapy Using Bracelet Electrodes In Women With Chronic Non-Specific Neck Pain: A Randomized Clinical Trial. Journal of Back and Musculoskeletal Rehabilitation 2025: 10538127251342557.
https://doi.org/10.1177/10538127251342557 DOI: https://doi.org/10.1177/10538127251342557
13. Candeniz Ş, Çitaker S, Maraş G, Yavuzer HE, Yildirim H, Günendi Z. Comparison Of The Effectiveness Of Instrument-Assisted Soft Tissue Mobilization And Extracorporeal Shock Wave Therapy In Myofascial Pain Syndrome. Turkish Journal of Medical Sciences 2023; 53(6): 1825-39.
https://doi.org/10.55730/1300-0144.5753 DOI: https://doi.org/10.55730/1300-0144.5753
14. Iakovidis P, Lytras D, Kasimis K, et al. Efficacy Of Myofascial Release With Transcutaneous Electrical Nerve Stimulation Conductive Glove For Neck Myofascial Syndrome: A Randomized Clinical Trial Study. Journal of Manipulative and Physiological Therapeutics 2023; 46(5-9): 254-70.
https://doi.org/10.1016/j.jmpt.2024.02.008 DOI: https://doi.org/10.1016/j.jmpt.2024.02.008
15. Prentice WE. Restoring Range Of Motion And Improving Flexibility Rehabilitation Techniques for Sports Medicine and Athletic Training: Routledge; 2024: 209-36. DOI: https://doi.org/10.4324/9781003526308-10
16. Kang T, Kim B. Cervical and scapula-focused resistance exercise program versus trapezius massage in patients with chronic neck pain: A randomized controlled trial. Medicine 2022; 101(39): e30887.
https://doi.org/10.1097/MD.0000000000030887 DOI: https://doi.org/10.1097/MD.0000000000030887
17. Anwar K, Arshad H, Taj S, Khalid M, Sajjad AG, Malik R. Effects Of Neuromuscular Reeducation With Ischemic Compression On Myofascial Trigger Points In Patients With Neck Pain- A Randomized Controlled Trial. Pakistan Journal of Medical & Health Sciences 2021; 15(12): 3673-3677.
https://doi.org/10.53350/pjmhs2115123673 DOI: https://doi.org/10.53350/pjmhs2115123673
18. Chitapure T, Sharma N, Malani R. Pain Neuroscience Education With Manual Therapy In Cervical Myofascial Pain Syndrome: A Case Report. Annals of the Romanian Society for Cell Biology 2021; 25(4): 11655-66.
Downloads
Published
License
Copyright (c) 2025 The Healer Journal of Physiotherapy and Rehabilitation Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
